You are on page 1of 2

4

TLS, have you I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
transmitted all R Action Date Signature
text files for this INSTRUCTIONS TO PRINTERS
cycle update? FORM 8891, PAGE 1 OF 2
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD O.K. to print
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
Date PERFORATE: None Revised proofs
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT requested

Form 8891 U.S. Information Return for Beneficiaries of
Certain Canadian Registered Retirement Plans
OMB No. 1545-0074

2005
Department of the Treasury Attachment
Internal Revenue Service 䊳 Attach to Form 1040. 䊳 See instructions on back of form. Sequence No. 139
Name shown on Form 1040 Identifying number (see instructions)

1 Name of plan custodian 2 Account number of plan

3 Address of plan custodian 4 Type of plan (check one box):
Registered Retirement Savings Plan (RRSP)
Registered Retirement Income Fund (RRIF)

5 Check the applicable box for your status in the plan (see Definitions in the instructions):
Beneficiary
Annuitant (Complete only lines 7a, 7b, and 8.)

6a Have you previously made an election under Article XVIII(7) of the U.S.–Canada income tax treaty to
defer U.S. income tax on the undistributed earnings of the plan? 䊳 Yes No

b If “Yes,” enter the first year the election came into effect and go to line 7a. If “No,” go to line 6c.

c If you have not previously made the election described on line 6a above, you can make an irrevocable
election for this year and subsequent years by checking this box 䊳

7a Distributions received from the plan during the year. Enter here and include on Form 1040,
line 16a 7a

b Taxable distributions received from the plan during the year. Enter here and include on
Form 1040, line 16b 7b

8 Plan balance at the end of the year. If you checked the “Annuitant” box on line 5, the “Yes” box
on line 6a, or the box on line 6c, stop here. Do not complete the rest of the form 8

9 Contributions to the plan during the year 9

10 Undistributed earnings of the plan during the year:

a Interest income. Enter here and include on Form 1040, line 8a 10a

b Total ordinary dividends. Enter here and include on Form 1040, line 9a 10b

c Qualified dividends. Enter here and include on Form 1040, line 9b 10c

d Capital gains. See the instructions for Form 1040, line 13, for how to report 10d

e Other income. Enter here and include on Form 1040, line 21. List type and amount 䊳

10e
For Paperwork Reduction Act Notice, see page 2. Cat. No. 37699X Form 8891 (2005)
4
I.R.S. SPECIFICATIONS TO BE REMOVED BEFORE PRINTING
INSTRUCTIONS TO PRINTERS
FORM 8891, PAGE 2 OF 2
MARGINS; TOP 13mm (1/2"), CENTER SIDES. PRINTS: HEAD TO HEAD
PAPER: WHITE WRITING, SUB. 20. INK: BLACK
FLAT SIZE: 216mm (8-1/2") x 279mm (11")
PERFORATE: None
DO NOT PRINT — DO NOT PRINT — DO NOT PRINT — DO NOT PRINT

Form 8891 (2005) Page 2

General Instructions Specific Instructions
Section references are to the Internal Revenue Code. All amounts listed must be in U.S. dollars.
Purpose of Form Name
Form 8891 is used by U.S. citizens or residents (a) to report
contributions to Canadian registered retirement savings plans Even if you are filing a joint Form 1040 with your spouse,
(RRSPs) and registered retirement income funds (RRIFs), (b) enter only your name.
to report undistributed earnings in RRSPs and RRIFs, and (c)
to report distributions received from RRSPs and RRIFs. See Identifying number
Notice 2003-75, which is available at www.irs.gov. Enter your U.S. social security number (SSN) or individual
Form 8891 also may be used to make an election pursuant taxpayer identification number (ITIN). Do not enter a
to Article XVIII(7) of the U.S.-Canada income tax treaty to Canadian identifying number.
defer U.S. income tax on income earned by an RRSP or an
RRIF that has been accrued, but not distributed. The
Beneficiaries
procedures for making the election are described in Revenue A beneficiary who has previously made the election to defer
Procedure 2002-23, which is available at www.irs.gov. income on the plan or is making it initially by checking the
Taxpayers who have not previously made the election under box on line 6c, must only complete lines 1 through 8 of the
Revenue Procedure 2002-23 may make it on this form. form.

Who Must File Annuitants
Form 8891 must be completed and attached to Form 1040 If you are treated as an annuitant for purposes of this form
by any U.S. citizen or resident who is a beneficiary of an (see Definitions), you should complete only lines 1 through 5,
RRSP or RRIF. A U.S. citizen or resident who is an annuitant 7a, 7b, and 8.
of an RRSP or RRIF must file the form for any year in which
he or she receives a distribution from the RRSP or RRIF. Line 6
A separate Form 8891 must be filed for each RRSP or If the election you made previously was made under Rev.
RRIF for which there is a filing requirement. If you and your Proc. 89-45, check the “No” box. If an election (other than an
spouse both must file Form 8891, you each must file a election under Rev. Proc. 89-45) was made for an RRSP, and
separate Form 8891. amounts from the RRSP were rolled over tax-free to an RRIF
or another RRSP, the election is considered to have been
Definitions made for the plan which received the tax-free rollover.
Beneficiary. A beneficiary of an RRSP or RRIF is an
individual who is subject to current U.S. income taxation on Line 7(b)
income accrued in the RRSP or RRIF or would be subject to For information on figuring taxable distributions, see section
current income taxation had the individual not made the 72 and Pub. 939, General Rule for Pensions and Annuities.
election under Article XVIII(7) of the U.S.–Canada income tax
treaty to defer U.S. income taxation of income accrued in the
RRSP or RRIF.
Paperwork Reduction Act Notice
Annuitant. For purposes of this form, an annuitant of an
RRSP or RRIF is an individual who is designated pursuant to We ask for the information on this form to carry out the
the RRSP or RRIF as an annuitant and is not also a Internal Revenue laws of the United States. You are required
beneficiary as defined above. to give us the information. We need it to ensure that you are
complying with these laws and to allow us to figure and
Record Retention collect the right amount of tax.
Taxpayers must retain supporting documentation relating to You are not required to provide the information requested
the information reported on Form 8891, including Canadian on a form that is subject to the Paperwork Reduction Act
forms T4RSP, T4RIF, or NR4, and periodic or annual unless the form displays a valid OMB control number. Books
statements issued by the custodian of the RRSP or RRIF. or records relating to a form or its instructions must be
retained as long as their contents may become material in
Other Reporting Requirements the administration of any Internal Revenue law. Generally, tax
returns and return information are confidential, as required by
Pursuant to section 6048(d)(4), annuitants and beneficiaries Internal Revenue Code section 6103.
who are required to file Form 8891 will not be required to file
Form 3520, and will not be subject to the associated The average time and expenses required to complete and
penalties described in section 6677 on such RRSPs or file this form will vary depending on individual circumstances.
RRIFs. For the estimated averages, see the instructions for your
income tax return.
You may be required to file Form TD F 90-22.1. See the
instructions for Form 1040. If you have suggestions for making this form simpler, we
would be happy to hear from you. See the Instructions for
your income tax return.